Organisational influences on evidence-based practice (EBP) within New South Wales acute stroke units

Abstract

Background: Prior to the Quality in Acute Stroke Care (QASC) trial we investigated organisational factors working as either barriers or enablers, liable to influence change within New South Wales stroke units. Method(s): A survey was administered to Nurse Unit Managers (NUMs) from 19 stroke units participating in the trial. The survey measured NUMs views of: self-leadership ability (as measured by the Leadership Practices Inventory [LPI]); organisational learning (as measured by the Organisational Learning Survey [OLS]); attitudes towards evidence-based practice (EBP); and stroke unit readiness for change. Result(s): Of the 19 (100%) NUMS that returned the survey, 16% (n = 3) had a post-graduate qualification. The mean values of the LPI of all subscales were in the upper third of the possible range between 6 and 60 indicating a high level of leadership. The mean score across all five learning capabilities of the OLS were above the midpoint of 4 on the seven-point scale indicating a culture of learning. NUMs attitudes towards EBP were positive (median 80, IQR 80-95 [0 = extremely unwelcoming to 100 = extremely welcoming]), although colleagues were perceived as less welcoming (median 70, IQR 60-80 [0 = extremely unwelcoming to 100 = extremely welcoming]). NUMs agreed (medium 3, 2-3.5 [1 = strongly disagree to 5 = strongly agree]) that using evidence in practice places unreasonable demands on their colleagues, 49% (n = 9) indicated that resources were not available for evidence implementation. Discussion(s): Although barriers to change existed, NUMs indicated that stroke units were ready for a practice change. Further studies are required investigating barriers to attaining post-graduate qualifications amongst stroke unit NUMs.